The digitalization in public administrations has seen, through the COVID-19 pandemic, the appearance of health surveillance technologies at the workplace. Wearable health devices, such as physiolytics, may then have an increasing role in the management of public agents. Still, little is known about the use of these systems in work settings, as research is mainly oriented towards ethical debates or legal considerations. Accordingly, we propose to consider a concrete case of implementation of physiolytics in a Swiss public administration. We particularly investigate employees’ use rates as well as the perceived opportunities and threats that are linked to physiolytics and health surveillance technologies. This is done through an action design research perspective, where we search to extract from the field guidelines and knowledge for practitioners. We especially highlight that physiolytics’ use steadily decline after the first weeks, due to the design of such devices, the fear of surveillance, and the impression of competition that these systems bring into the workplace. It is therefore vital for public managers to introduce interventions, such as regular feedback, gamification, or nudging to support the engagement of public agents and ensure the viability of such novel health initiatives.